REFERRAL & PRECERT SPEC

Covenant Health•Knoxville, TN

28d

About The Position

The Referral & Precert Specialist directs daily scheduling operations for inpatient and outpatient procedures and services and obtains necessary referrals and pre-certifications. The role coordinates scheduling details among patients, providers, facilities, and care team members, while maintaining accurate documentation and tracking. The position is with Cardiology Associates of East Tennessee, part of Covenant Medical Group, Covenant Health’s employed and managed medical practice organization serving communities across East Tennessee.

Requirements

Medical terminology knowledge is required.
Knowledge of ICD-9 and CPT coding.
Basic computer skills.
Education and/or prior work experience sufficient to demonstrate the knowledge, skill, and ability needed for the essential job tasks, typically equivalent to a high school diploma or GED; preference may be given to candidates with a high school diploma or GED.

Nice To Haves

Previous referral or pre-certification experience is preferred.

Responsibilities

Schedule inpatient and outpatient tests, procedures, and appointments as directed by the provider, and document each scheduled event in detail in the medical record file.
Complete all forms required for referrals and pre-certifications accurately.
Apply knowledge of requirements and guidelines mandated by insurance plans, hospitals, and outpatient facilities.
Maintain accurate testing, referral, and appointment logs, including follow-up verification in the referral tracking database.
Coordinate procedure or appointment dates, times, and locations with the patient, facility, and provider.
Communicate appointment details and any special instructions to the patient.
Report problems obtaining referrals, pre-certifications, or appointments ordered by the provider.
Perform other duties as assigned or requested.
Attend required meetings and participate on committees as directed.
Collaborate with the patient, physician, and other care team members as part of a team-based approach to patient care.